革兰氏阳性杆菌引起颏部阶梯截骨前移术后感染的经验和教训

目的：通过1例颏部阶梯状截骨术治疗严重小颏畸形术后感染患者的治疗，分析感染可能发生的原因和治疗措施，为临床颏部整形工作提供经验教训，提醒临床医师重视临床少见的革兰氏阳性杆菌引起的感染。方法：对1例小颏畸形患者进行颏部阶梯状截骨手术，术后1个月左右出现感染，通过细菌培养，彻底清创，全身抗炎治疗和局部换药进行治疗，并对感染发生的原因进行分析。结果：致病菌为苹兰氏阳性杆菌，死腔、发育不良、口腔卫生差是感染发生的可能原因。治疗后感染得到良好控制，外形较术前明显改善。结论：死腔、异物和全身发育不良或局部卫生条件差会增加感染的几率。

Experience and lesson from infection of genioplasty with two-step osteotomy by gram-positive bacilli

Objective Analysis on the possible causes and treatment of a patient with infection after genioplasty with two- step osteotomy.To draw a lesson from the case and reminde plastic surgeons of the gram-positive bacilli. Methods Genioplasty with two-step osteotomy was give to a patient suffering from severe microgenia.lnfection occurred one month after surgery, she was treated with bacterial culture, sensitivity test,surgical debride and antibiotics therapy total and local body. Results The conditional pathogen is gram-positive bacillus.Dead space,hypogenesis and poor oral hygiene might be the causes of the infection. Infection was controlled well, the chin figure was good. Conclusion Dead space,hypogenesis, poor oral hygiene and foreign body might cause the infection.